Tag Archives: painkillers

Written opioid prescriptions drop 10 percent in Wisconsin

A system to track prescription painkillers in Wisconsin to prevent abuse shows a nearly 10 percent drop in the number of opioid prescriptions written and filled compared to this time last year.

Wisconsin’s Controlled Substance Board recently published its first quarterly report on the prescription drug monitoring database, which was established in 2013, Wisconsin Public Radio reported.

The report does not say what percentage of doctors, dentists or pharmacists check the database, but officials said its use has steadily increased. Doctors will be required to check it next year.

The Wisconsin Medical Society’s chief medical officer, Donn Dexter, said the organization is working to educate physicians on the database and get them ready for the mandates.

A year after the database started in 2014 only 30 percent of pharmacists used the database and 8 percent of doctors. Dexter said with the new database implemented in January that number is sure to go up.

“The reason it wasn’t used is I think our doctors are already very busy,” Dexter said.

He said it is challenging to implement because it’s difficult to use.

The purpose of the database is to crackdown on patients getting various prescriptions from doctors and filling the same prescription with multiple pharmacists.

“One thing that the Medical Society is working hard on is that the pendulum doesn’t swing too far; so that patients that need pain control still get pain control,” said Dexter.

Law enforcement also uses the database most commonly for stolen prescriptions.

By sharing painkillers, friends and family can fuel opioid epidemic

As lawmakers grapple with how best to combat the nation’s prescription drug abuse crisis, a recent survey is shedding light on how patients who get these painkillers  — drugs such as OxyContin, methadone or Vicodin — sometimes share or mishandle them.

According to findings detailed in a research letter published Monday in JAMA Internal Medicine, about one in five people who were prescribed the highly addictive drugs reported having shared their meds with a friend, often to help the other person manage pain. Most people with a prescription either had or expected to have extra pills left after finishing treatment. And almost 50 percent didn’t know how to safely get rid of the drugs left over after their treatment was complete, or how to store them while going through treatment.

The study’s authors suggested that the results point to changes doctors could make in prescribing practices and counseling to help alleviate the problems.

“We’ve all been saying leftover medications are an issue,” said Wilson Compton, deputy director of the federal National Institute on Drug Abuse, who wasn’t involved with the study. “Now I have a number that is concerning.”

The survey was sent to a random sample of almost 5,000 people in 2015. Of the recipients, about 1,000 had used prescription painkillers in the past year. Almost all of the people in this group responded to the survey.

Public concerns about painkiller abuse are growing louder. About 2 million people were addicted to prescription opioids in 2014, the most recent year for which data is available, according to the Centers for Disease Control and Prevention. Overdoses kill 44 people per day, the U.S. Department of Health and Human Services estimates. Researchers say deaths in 2014 were almost four times as common as they were in 2000.

“There’s a growing awareness among medical advisers, policymakers and even members of the general public that these are medications that can do serious harm,” said Colleen Barry, one of the study’s authors. She is a professor of health policy at Johns Hopkins University and co-director of the university’s Center for Mental Health and Addiction Policy Research.

And it is not news that most people who use prescription painkillers for nonmedical reasons often get them through social channels rather than a physician. In 2013 — the most recent year for which this data is available — the National Survey on Drug Use and Health estimated that number to be more than 80 percent.

But this paper’s findings illustrate some of the forces behind drug-sharing, Barry said, and in turn indicate how to stop it. For instance, the authors recommend that doctors prescribe smaller amounts of drugs, to minimize leftovers that could be shared or stolen. That tracks with new opioid prescribing guidelines issued by the Centers for Disease Control and Prevention.

“We probably prescribe a little bit more than we need to, and it’s not like people throw these away afterward. The leftovers are something we’re not thinking about,” said Jonathan Chen, an instructor at Stanford University School of Medicine, who has researched opioid abuse. Chen, who was not involved in the study, is also a practicing physician.

Meanwhile, it’s still tough for people to get rid of the drugs when they finish with them, and few say they know about safe storage practices. That’s another avenue for prevention.

Most respondents, for instance, didn’t lock up the pills when storing them. That makes it easier for someone else to take them.

And the prevalence of sharing medications suggests consumers need to be better educated about how addictive prescription opioids are, Barry said.

Doctors, added NIDA’s Compton, also need to understand the risk that, when they prescribe pills, they could end up used by someone else.

“One out of five people that I write a prescription to for opioids may share those with someone else. That’s a lot of people,” he said.

Physicians, meanwhile, haven’t historically been trained to counsel patients on safe drug disposal, meaning patients are often left unaware. Just under a quarter of respondents reported they remembered learning from the doctor or nurse about how to get rid of their meds safely. Chen said he couldn’t recall ever going over disposal practices with a patient. Even if he did, he said, it’s hard to know if patients would remember that information.

And when they are informed, it’s still difficult for consumers to easily get rid of pills they no longer need. The federal Drug Enforcement Administration sponsors “drug take-back days” twice a year. Some local law enforcement agencies hold similar events. But such events are often sporadic enough that it’s hard to make them a real habit, Barry noted.

Making those practices easier is essential, Barry said. And changing the culture around those drugs is key, so people understand the risk.

“Just the realization on the part of the public as well as physicians that these medications are not like Tylenol — these are highly addictive meds,” she said. “That message is starting to get out there.”

Published under a Creative Commons License courtesy of Kaiser Health News, a national health policy news service that is part of the nonpartisan Henry J. Kaiser Family Foundation.

Ethics complaints filed by Republicans against Sen. Baldwin are dismissed

The Senate ethics panel has dismissed three complaints filed by Republicans against Democratic U.S. Sen. Tammy Baldwin over her firing of a top-level staff member and handling of allegations at the Tomah Veterans Affairs Medical Center.

Baldwin on Thursday released an Aug. 14 letter from the U.S. Senate Select Committee on Ethics notifying her that the ethics complaints had been dismissed because they lacked merit. All three related to the firing of Baldwin’s former deputy state director Marquette Baylor and allegations that Baldwin mishandled a whistleblower’s reports of abuse at the VA hospital.

“It should be clear to everyone that these frivolous allegations are false and were nothing more than political smears,” Baldwin’s spokesman John Kraus said in a statement. “Senator Baldwin has not let these political attacks distract from the important work she has done working with Wisconsin veterans and their families to bring reform to the VA.”

Baylor, the Republican Party of Wisconsin and the Foundation for Accountability and Civic Trust in April requested an investigation into Baldwin’s handling of abuse allegations at the Tomah Veterans Affairs hospital and Baylor’s firing in January.

Baylor alleged in her complaint that Baldwin used her as a scapegoat in the office’s mishandling of reports of overprescribing of narcotics and retaliatory behavior at the hospital.

Baldwin said in February that Baylor was terminated due to long-term performance issues that weren’t exclusive to her dealing with concerns about the Tomah hospital. The senator later admitted responsibility for her staff’s mishandling of reports.

The committee told Baldwin the complaints lacked substantial merit and did not sufficiently allege facts or provide evidence of a violation of law, Senate rule or regulation. The committee plans to take no further action and closed the complaints, its lead attorney Deborah Sue Mayer told Baldwin.

“It is up to the people of Wisconsin to determine whether Senator Baldwin’s actions were appropriate,” Baylor’s attorney Todd Graves said in an email in reaction to the dismissal.

Messages left with the Wisconsin Republican Party and FACT were not immediately returned.

A VA report in March month concluded that patients at the Tomah facility were more likely than patients at other VA hospitals to receive high doses of pain killers. The report also said there was an atmosphere of fear among staff members that affected patient care.

In August, the VA’s inspector general said deficiencies in care led to the mixed drug toxicity death last year of Jason Simcakoski, a 35-year-old Marine Corps veteran from Stevens Point. The director of the Tomah facility was fired in September.

GOP lawmaker addresses heroin addiction in Wisconsin in response to daughter’s struggle

A Republican lawmaker whose daughter has struggled with heroin addiction announced Tuesday he plans to introduce another round of legislation focusing on opiate prescriptions that can lead to heroin abuse.

Rep. John Nygren of Marinette spearheaded seven bills designed to curtail heroin abuse and help addicts recover last session. He told reporters during a news conference Tuesday he has four more bills ready to go. Assembly Speaker Robin Vos, R-Rochester, Dr. Tim Westlake, vice chairman of the state Medical Examining Board and a member of the state’s controlled substance board, and Wisconsin Attorney General Brad Schimel all stood with Nygren in a show of support.

Nygren said the new bills are designed to attack the root of the problem — addictions to opiate prescriptions that pave the path to heroin.

“As we said last session, there were no silver bullets contained in those seven pieces of legislation,” Nygren said. “We knew that we had more that needed to be done.”

The new legislation would require anyone who dispenses opiates to enter the prescriptions in a statewide tracking database within 24 hours rather than the seven days currently allowed under state law. Doctors would be required to check the database before prescribing opiates. Nygren said those moves could help identify addicts and doctors who are overprescribing.

Police who discover an opiate prescription at the scene of an overdose would have to enter the prescription in the database and notify the prescribing physician of the incident.

The package also would create registries for pain and methadone clinics. Nygren said little is known about how such clinics operate.

Nygren’s daughter Cassie has battled a heroin addiction for several years. She was sentenced to a year and a half in prison in 2009. She pleaded guilty this past March to felony narcotic possession and was sentenced to drug court.

Nygren has often cited her story in his push to advance anti-heroin legislation. His bills last session included measures that funded additional treatment facilities; established immediate punishments for parole and probation violators and immunity for anyone who reports an overdose; and allowed first-responders with training to administer Narcan, a drug that counteracts heroin overdoses. Gov. Scott Walker signed the proposals into law last spring after all seven bills passed the Assembly and Senate unanimously.

Myranda Tanck, a spokeswoman for Senate Majority Leader Scott Fitzgerald, R-Juneau, said Fitzgerald hasn’t discussed the new bills specifically with his caucus but supports efforts “to fight narcotic abuse in Wisconsin.”

Sen. Sheila Harsdorf, R-Hudson, appeared at the news conference to support Nygren, calling the bills “common sense reforms.” Sen. Alberta Darling, R-River Hills, who co-chairs the Legislature’s powerful budget committee with Nygren, issued a statement saying she stands with him, too.

A Walker spokeswoman didn’t immediately respond to an email seeking comment on Nygren’s bills.

Nygren said he still wants to address a shortage of treatment beds, detoxification centers that won’t accept active drug users and help recovering addicts stay sober and remain employed. He didn’t offer any details.